{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T14:54:01Z","timestamp":1766415241556},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,1,25]],"date-time":"2014-01-25T00:00:00Z","timestamp":1390608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Comm Dent Oral Epid"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label \/><jats:p>Oral cancer is a substantial, often unrecognized issue globally, with close to 300\u00a0000 new cases reported annually. It is a management conundrum: a cancer site that is easily examined; yet more than 40% of oral cancers are diagnosed at a late stage when prognosis is poor and treatment can be devastating. Opportunistic screening within the dental office could lead to earlier diagnosis and intervention with improved survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe how clinicians make decisions about referral based on the risk classification of the lesion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighteen dentists from 15 dental offices participated in a 1\u2010day workshop on oral cancer screening. Participants then screened patients (medical history, conventional oral exam, fluorescent visualization examination) in\u2010office for 11\u00a0months, triaging patients by apparent clinical risk: low risk (common benign conditions, geographic tongue, candidiasis, trauma), intermediate risk (lichenoid lesions) and high risk (white or red lesions or ulcers without apparent cause). Clinicians made the decision on which lesions to reassess in 3\u00a0weeks based on risk assessment and clinical judgment. Lesions of concern were seen by a community facilitator or referred to an oral medicine specialist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2542 patients were screened, and 389 lesions were identified (15% of patients). 350 were determined to be low risk (90%), 19 intermediate risk (<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>) (5%), and 20 high risk (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>) (5%). One hundred and sixty\u2010six (43%) patients were recalled for 3\u2010week reassessment: 90% of <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> lesions, 63% of <jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> lesions (63%), and 39% of low\u2010risk lesions. Compliance to recall was high (92% of cases). Reassessment eliminated the referral of 99\/166 (60%) of lesions that had resolved. six lesions were biopsied with three low\u2010grade dysplasias identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Three key decision points were tested: risk assessment, need for reassessment, and need for referral. A 3\u2010week reassessment appointment was invaluable to prevent the unnecessary referral due to confounders. There is a need for a well\u2010defined triage pathway to facilitate oral cancer screening and a methodical and consistent approach to opportunistic screening in the dental office.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cdoe.12093","type":"journal-article","created":{"date-parts":[[2014,1,25]],"date-time":"2014-01-25T07:28:05Z","timestamp":1390634885000},"page":"375-384","source":"Crossref","is-referenced-by-count":25,"title":["Decision making on detection and triage of oral mucosa lesions in community dental practices: screening decisions and referral"],"prefix":"10.1111","volume":"42","author":[{"given":"Denise M.","family":"Laronde","sequence":"first","affiliation":[{"name":"Faculty of Dentistry Department of Oral Biological and Medical Sciences University of British Columbia Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. M.","family":"Williams","sequence":"additional","affiliation":[{"name":"BC Cancer Agency\/Cancer Research Centre Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. G.","family":"Hislop","sequence":"additional","affiliation":[{"name":"School of Population and Public Health University of British Columbia Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Poh","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry Department of Oral Biological and Medical Sciences University of British Columbia Vancouver BC Canada"},{"name":"BC Cancer Agency\/Cancer Research Centre Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samson","family":"Ng","sequence":"additional","affiliation":[{"name":"Vancouver Hospital and Health Sciences Centre Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lewei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry Department of Oral Biological and Medical Sciences University of British Columbia Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam P.","family":"Rosin","sequence":"additional","affiliation":[{"name":"BC Cancer Agency\/Cancer Research Centre Vancouver BC Canada"},{"name":"Department of Biomedical Physiology and Kinesiology Simon Fraser University Burnaby Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,1,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20006"},{"key":"e_1_2_6_3_1","unstructured":"BoyleP LevinB.World Cancer Report.2008."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2012.11.004"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.56.1.11"},{"key":"e_1_2_6_6_1","first-page":"1009","volume-title":"The Canadian guide to clinical preventive health care","author":"Canadian Task Force on the Periodic Health Examination.","year":"1994"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2010.0223"},{"key":"e_1_2_6_8_1","first-page":"CD004150","article-title":"Screening programmes for the early detection and prevention of oral cancer","volume":"11","author":"Brocklehurst P","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_9_1","first-page":"1","article-title":"Opportunistic oral cancer screening","volume":"6","author":"British Dental Association.","year":"2000","journal-title":"BDA News"},{"issue":"1","key":"e_1_2_6_10_1","first-page":"87","article-title":"UK working group on screening for oral cancer and precancer: conclusions and recommendations","volume":"10","author":"Speight PM","year":"1993","journal-title":"Community Dent Health"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta10140"},{"key":"e_1_2_6_12_1","unstructured":"Statistics Canada.Table 105\u20100460 \u2010 Contact with dental professionals in the past 12\u00a0months by age group and sex household population aged 12 and over Canada provinces territories health regions (June 2005 boundaries) and peer groups every 2\u00a0years CANSIM (database)2005; available at:http:\/\/cansim2.statcan.gc.ca\/cgi-win\/cnsmcgi.exe?Lang=E&CNSM-Fi=CII\/CII_1-eng.htm. [last accessed 27 August 2009]."},{"key":"e_1_2_6_13_1","unstructured":"National Center for Chronic Disease Prevention and Health Promotion.National Oral Health Surveillance System Dental Visit: Center for Disease Control and Prevention;2004; available at:http:\/\/apps.nccd.cdc.gov\/nohss\/ListV.asp?qkey=5&DataSet=2. [last accessed 11 June 2009]."},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2000.0201"},{"key":"e_1_2_6_15_1","first-page":"415","article-title":"Oral and pharyngeal cancer: knowledge and opinions of dentists in British Columbia and Nova Scotia","volume":"68","author":"Clovis JB","year":"2002","journal-title":"J Can Dent Assoc"},{"key":"e_1_2_6_16_1","first-page":"245","article-title":"Guideline for the early detection of oral cancer in British Columbia 2008","volume":"74","author":"Early Detection of Oral Cancer Working Group.","year":"2008","journal-title":"J Can Dent Assoc"},{"key":"e_1_2_6_17_1","first-page":"275","article-title":"Evaluation of a suspicious oral mucosal lesion","volume":"74","author":"Williams PM","year":"2008","journal-title":"J Can Dent Assoc"},{"key":"e_1_2_6_18_1","first-page":"269","article-title":"Oral cancer: just the facts","volume":"74","author":"Laronde DM","year":"2008","journal-title":"J Can Dent Assoc"},{"key":"e_1_2_6_19_1","first-page":"255","article-title":"Is the message clear? Talking with you patient about oral cancer screening","volume":"74","author":"Currie BL","year":"2008","journal-title":"J Can Dent Assoc"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2000.0239"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.2193157"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20468"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2011.00386.x"},{"key":"e_1_2_6_24_1","unstructured":"Health Canada.Canadian Tobacco Use Monitoring Survey (CTUMS)2009; available at:www.hc-sc.gc.ca. [last accessed 13 August 2009]."},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.4810069"},{"key":"e_1_2_6_26_1","first-page":"263","article-title":"Alcohol consumption and the risk of cancer","volume":"26","author":"Bagnardi V","year":"2001","journal-title":"Alcohol Res Health"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-08-0347"},{"key":"e_1_2_6_28_1","first-page":"239","article-title":"Voices from the community\u2013experiences from the dental office: initiating oral cancer screening","volume":"74","author":"Laronde DM","year":"2008","journal-title":"J Can Dent Assoc"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/152483990100200309"},{"key":"e_1_2_6_30_1","first-page":"421","article-title":"Oral and pharyngeal cancer: practices and opinions of dentists in British Columbia and Nova Scotia","volume":"68","author":"Clovis JB","year":"2002","journal-title":"J Can Dent Assoc"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn514"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn306"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djk179"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/00008469-200108000-00014"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2001.0175"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2005.0089"}],"container-title":["Community Dentistry and Oral Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcdoe.12093","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cdoe.12093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T16:46:26Z","timestamp":1696351586000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cdoe.12093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,1,25]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2014,8]]}},"alternative-id":["10.1111\/cdoe.12093"],"URL":"https:\/\/doi.org\/10.1111\/cdoe.12093","archive":["Portico"],"relation":{},"ISSN":["0301-5661","1600-0528"],"issn-type":[{"value":"0301-5661","type":"print"},{"value":"1600-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,1,25]]}}}